When people appear self-obsessed or driven by “clout-chasing,” the term “narcissism” may be used to define their behavior. However, when it comes to narcissistic personality disorder (NPD), signs and symptoms go much deeper than self-absorbed characteristics.

Throughout this article, we’ll explore everything you need to know about this type of personality disorder.

Signs & Symptoms

A narcissistic personality disorder (NPD) is defined by an idealized self-image and avoidance of deep feelings. Especially those that bring about negative emotions, such as criticism. ¹

While not everyone with the condition will struggle with the same symptoms, the most common include:

• An exaggerated sense of self-importance
• Arrogant conduct
• Belief that they’re superior to others (and people are envious of them)
• Entitlement (constant need for admiration)
• Envious of those who are more successful
• Expecting superior recognition even without achievement
• Manipulate others to get what they want
• Occupied with daydreams of success and power
• Over-exaggerate achievements or skills
• Require compliance with their expectations
• Take full control of conversations (belittle those they believe are inferior)
• Unable to recognize others’ feelings and needs

Simultaneously, people with NPD also have difficulty seeing the world from another’s perspective. More specifically, they don’t take well to criticisms when directed toward them:

• Difficulty with emotion and behavioral regulation
• Experiencing depression (as they don’t match perfection)
• Impatient and angry when not receiving special treatment
• Inability to adapt to change and handle stress
• React with rage to make themselves feel superior
• Secretly insecure, shameful, and vulnerable
• Severe interpersonal problems

Causes

Researchers currently don’t understand what causes NPD. As a type of personality disorder, we know that the development of this condition is complex and likely a factor of the following:

• Environment – The impact of childhood on an individual may develop into NPD. For example, a child who receives excessive admiration (or criticism) may be more vulnerable to the condition. ²

• Genetics – If a close family member (i.e. parent or sibling) has NPD, an individual related to that member is more likely to have it. However, this may be because of the family member’s influence. ³

• Neurobiology – There are likely brain structure malformations in people with NPD, affecting their way of behavior and thinking. ⁴

Furthermore, NPD is more likely to occur in men than women. Not to mention, the condition usually develops at a later age than early on in life.

With that said, some children may show signs or symptoms of NPD. However, such traits are common among children of specific ages. Therefore, they’re not signs of NPD itself.

Complications

If you struggle with NPD, there’s a chance you’ll develop the following complications in life:

• Anxiety
• Depression
• Difficulty with relationships
• Drug and alcohol abuse
• School or work issues
• Suicidal ideation

If you or a loved one struggles with suicide, help is available. In cases of emergency, call 911. In all other cases, you can reach out to the 988 Suicide & Crisis Lifeline.

Prevention

Since the causes of NPD aren’t known, prevention of this condition is also up in the air. Still, for those who may be vulnerable to NPD, we recommend:

• Finding treatment as soon as possible (see more below)
• Seek guidance even when you feel you don’t need it
• Talk about your emotions and conflicts with loved ones

Diagnosis

Since the signs and symptoms of NPD are largely similar to those of other personality disorders, diagnosing the condition can be a challenge. To determine whether or not you struggle with it, a medical professional will provide you with the following:

• Psychological evaluation (to see if you struggle with another mental health disorder)
• Physical exam (to ensure you don’t struggle with another medical ailment)
• Signs and symptoms analysis for NPD

Keep in mind that it’s common for people with NPD to also struggle with other personality disorders. Therefore, you may receive a diagnosis and subsequent treatment for other conditions. ⁵

Treatment

To treat NPD, medical professionals will take two direct approaches:

1.) Psychotherapy

As the primary treatment for the condition, psychotherapies help to identify where your emotions come from and work to develop better relationships with others.

More specifically, psychotherapy will help you overcome the following:

• How to accept and maintain personal relationships
• Increase your understanding of emotions
• Release idealizations of yourself
• Understand your self-esteem
• When to recognize and accept your competence

If you learn to manage your NPD, therapy can be a short-term endeavor. However, in more severe cases, long-term therapy is ideal for battling this condition.

2.) Medication

Currently, there are no medications to treat NPD. However, if you’re diagnosed with another condition (such as anxiety or depression), you may receive medication to help treat that disorder.

Final Word

While it may seem as though people with NPD aren’t looking for help, deep down, they’re crying out for an answer. The best way for them to find this answer is through psychotherapy as it allows an open conversation to identify signs and symptoms.

Admittedly, battling NPD comes with complications not found in other mental health disorders. Therefore, loved ones need to be there every step of the way.

References

¹ Mitra P, Torrico TJ, Fluyau D. Narcissistic Personality Disorder. [Updated 2024 Mar 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556001/

² Kernberg PF. Narcissistic personality disorder in childhood. Psychiatr Clin North Am. 1989 Sep;12(3):671-94. PMID: 2798202.

³ Luo YL, Cai H, Song H. A behavioral genetic study of intrapersonal and interpersonal dimensions of narcissism. PLoS One. 2014 Apr 2;9(4):e93403. doi: 10.1371/journal.pone.0093403. PMID: 24695616; PMCID: PMC3973692.

⁴ Nenadić I, Lorenz C, Gaser C. Narcissistic personality traits and prefrontal brain structure. Sci Rep. 2021 Aug 3;11(1):15707. doi: 10.1038/s41598-021-94920-z. PMID: 34344930; PMCID: PMC8333046.

⁵ Kacel EL, Ennis N, Pereira DB. Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness. Behav Med. 2017 Jul-Sep;43(3):156-164. doi: 10.1080/08964289.2017.1301875. PMID: 28767013; PMCID: PMC5819598.